Abstract
Purpose
The Canadian Society for Medical Laboratory Science (CSMLS) Peer Support Project was a formal and virtual peer support group pilot for medical laboratory professionals in Canada to determine its application for CSMLS members and obtain information regarding the current state of medical laboratory professionals’ mental health, well-being and burnout. CSMLS learned what is contributing to stress at work, coping strategies and barriers to accessing support or help for their mental health among medical laboratory professionals.
Design/methodology/approach
The qualitative and exploratory pilot study examined medical laboratory professionals from Canada. Two peer support groups were facilitated in April and May 2022 by a trained mental health clinician. Peer support delivery was virtual and delivered via Zoom. The purposive sample featured medical laboratory technologists, Educators and Supervisors/Directors who were CSMLS members. The qualitative analysis was conducted via analytical memos and incorporated both manual and NVivo software analysis.
Findings
Overall themes were identified within the data analysis and included barriers to mental health care; increased stigma for mental health; mixed messaging regarding mental health; feeling invisible; medical laboratory professionals would like to manage stress better but their increasing workload demands and challenges with scheduling and staffing add to their stress. Participants also highlighted their role and its context using metaphors such as “the silent firefighters”, and “the Bass Guitar of the Hospital”. Based on the evaluations, the peer support sessions encouraged participants to address their own mental health, validate their experiences and increase their comfort level in discussing mental health.
Social implications
It identified a potential resource for medical laboratory professionals and determined that further mental health resources would be beneficial for their field. It also identified their strong commitment to patient care and their role as a medical laboratory professional.
Originality/value
To the best of the authors’ knowledge, this study is one of the first to examine peer support as a mental health resource for medical laboratory professionals. Additionally, its focus was on a Canadian population with virtual delivery.
Keywords
Citation
Mete, R.E., Djukic, B. and Nielsen, C. (2024), "The “Silent Firefighters”: an examination and evaluation of peer support sessions for medical laboratory professionals in Canada", Mental Health and Digital Technologies, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/MHDT-01-2024-0001
Publisher
:Emerald Publishing Limited
Copyright © 2024, Emerald Publishing Limited
Introduction
There are numerous studies examining stress and coping among health-care professionals but many focus on nursing or physicians (Søvold et al., 2021). However, medical laboratory professionals are a key component of any health-care system and experience stress within the lab (Kroft, 2020). In Canada, medical laboratory professionals consist of medical laboratory technologists (MLTs) and medical laboratory assistants (MLAs). MLTs “conduct a full range of laboratory tests, from routine to complex to provide information necessary for the diagnosis and treatment of disease”. In Canada, certifications in the general lab, diagnostic cytology and clinical genetics are available. General MLTs may specialize in areas including clinical chemistry, clinical microbiology, hematology, transfusion science and histology (CSMLS, 2024). In comparison, MLAs “collect and process biological specimens to perform laboratory tests” (Leber et al., 2022, p. 3).
The Canadian Society for Medical Laboratory Science (CSMLS) is the national certifying body for MLTs and MLAs and the national professional society for Canada’s medical laboratory professionals. CSMLS provides advocacy, information and conducts relevant research for its members while sustaining professional practice standards within the field of medical laboratory science and its specialties.
The landscape of the profession is constantly changing, and members began to discuss their mental health more frequently, in 2018 and even earlier. CSMLS began to develop further resources and conduct research regarding mental health (Grant et al., 2016). It became obvious that medical laboratory professionals were interested in learning more and developing skills for their mental health and emotional well-being. While their levels of emotional exhaustion and burnout have escalated in recent years, their levels of personal accomplishment continued to increase which is an interesting phenomenon (Djukic, 2021).
The combination of member feedback, research and the phenomenon led to the investigation and development of testing another potential member resource by CSMLS: peer support sessions. In the literature, peer support is well-researched as addressing individuals with mental and physical health concerns (Naslund et al., 2016; Shalaby and Agyapong, 2020).
Peer support is:
A process through which people who share common experiences or face similar challenges come together as equals to give and receive help based on the knowledge that comes through shared experience (Penney, 2018, p. 1).
As a result, peer support “promotes person-centred recovery by enabling contact between people with lived experience to foster a sense of connectedness by communicating shared experiences” (Ibrahim et al., 2020, p. 285). Formal peer support occurs when a trained individual provides support, guidance and structure for the group of individuals, whereas informal peer support may occur between colleagues on a general basis.
The current research landscape examined the implementation and benefits of peer support among nurses, physicians, midwives, residents and students (Moir et al., 2016; van Buschbach et al., 2020; Schrøder et al., 2022). The studies focused on peer support and its impact on burnout as well as peer support after adverse events (Lane et al., 2018; Peterson et al., 2008; Shapiro and Galowitz, 2016). One study at present examined peer-assisted learning among medical laboratory students in Africa, however, there was no research regarding the impact of peer support among medical laboratory professionals (Osman et al., 2022). Consequently, the CSMLS peer support pilot is the first of its kind among medical laboratory professionals.
Furthermore, the peer support sessions’ pilot results allowed CSMLS to determine its suitability for their members in addressing their mental health, burnout and emotional well-being. Due to the consistent workload demands, the peer support sessions examined the concept of retention and the role of a medical laboratory professional. Additionally, discussion regarding availability and access to mental health programmes/resources was facilitated. However, with CSMLS’ national profile and the ongoing COVID-19 pandemic, it was apparent that a virtual delivery of peer support would allow for ease of access across the country. The article outlined this new initiative facilitated via Zoom along with its results, implications and lessons learned.
Methodology
The peer support project was an exploratory and qualitative study. It was approved by the organization’s Research Ethics Board board. The sample population for the pilot and subsequent qualitative research were CSMLS members including MLTs, MLAs, Educators and those in Managerial/Director positions. Within qualitative research, the type of sampling used is called purposive sampling to ensure the rich collection of data:
It is a nonrandom technique that does not need underlying theories or a set number of participants […] the researcher decides what needs to be known and sets out to find people who can and are willing to provide the information by virtue of knowledge or experience (Etikan et al., 2016, p. 3).
The peer support project was advertised via email and the information was posted on CSMLS’ social media, specifically Facebook, Instagram and Twitter. Participants confirmed their interest in the study, their attendance for four weekly Zoom sessions and their preferred day and times (in Eastern Standard Time) via SurveyMonkey. Additionally, participants provided their contact information.
Based on responses, two groups were established on Thursdays in April and May 2022. Informed consent forms were emailed to participants via JotForm which they signed prior to the start of the April and May sessions. Participants were emailed a secure Zoom link from the facilitator, who used Zoom Business with enhanced privacy settings. The informed consent and privacy policies were reviewed at the start of each peer support session in April and May 2022. Participants were also informed that their device cameras were to stay on for each session.
Furthermore, the informed consent also outlined an incentive for participation in all four sessions. There was a random draw for two participants who completed all four sessions. For each group, two participants were randomly drawn after the conclusion of the last session and received a $25 Amazon gift card via email. Additionally, an anonymous electronic evaluation form was emailed via JotForm to all participants at the end of the fourth session (see Appendix 1).
Participants in session
April sessions
Within the April sessions, 11 participants confirmed attendance however eight participants attended the first session, five participants attended the second session and seven participants attended the third and fourth sessions. The majority of participants attended three sessions in total. Please see Table 1 below for the overview of participants and roles. From the original 11, two participants were unable to attend due to their work schedule changes, which is common among the medical laboratory profession. Additionally, other scheduled commitments, issues with time zone conversion and COVID impacted negatively on participation, either through being ill from COVID or the necessity of caring for family members, especially children.
In April, four participants were from Ontario, with the remaining participants from Alberta, Manitoba, Newfoundland and Nova Scotia. Three participants had 25+ years of experience, and three participants had 15+ years of experience, while the remainder had less than ten years of experience. Half of the participants were from urban areas within Canada, while the others were from rural or remote areas within Canada. One MLT was internationally educated while the remaining were educated in Canada. All participants identified as female.
In the April group, all participants were MLTs and two were Supervisor/Directors (see Table 1). Some of the MLTs had also previously been in Educator roles or were part of training programmes. This information was provided via the survey and confirmed in the sessions by participants. The MLTs’ scope of practice included histology, hematology and microbiology.
May sessions
Within the May sessions, there were seven participants in the first and second sessions, six participants in the third session and five participants in the last session (see Table 2). One participant was unable to return due to other obligations and the other was travelling on the day of the last session. Of the seven participants, four were from rural or remote areas of Canada and the remainder were from urban areas within Canada. Two participants were from Ontario while one participant came from each of the following provinces: British Columbia, Alberta, Manitoba, Prince Edward Island and Nova Scotia. All participants were MLTs, however, one individual also identified as a Supervisor/Director and one identified as an Educator as their main role in the survey. This information was provided via the survey and confirmed in the sessions by participants. Additionally, all participants identified as female which was also confirmed within the May sessions by personal pronoun usage. Three participants outlined disciplines in cytotechnology, microbiology and hematology while the others worked within the broader lab. All participants were educated in Canada.
Mental health support
Due to the sensitive nature of the topics discussed, the facilitator ensured that a link to free mental health services for Canadians (Wellness Together) was provided in the consent form. Additionally, the facilitator was available after sessions for support. The facilitator also provided further mental health strategies within sessions and at the end of the sessions, mental health resources were provided that encompassed federally and provincially funded (no cost) services, crisis services, as well as resources from CSMLS such as articles and workshops that are available to members. CSMLS also has an evidence-based free resource, the Mental Health Toolkit, which is available online.
Facilitator background
The research notes that a peer support worker normally has the same experience as individuals within the group. However, for this pilot project, CSMLS was aware of the sensitive nature of the topics to be discussed and wanted to ensure that participants were supported. Therefore, the facilitator was chosen based on her experience with medical laboratory professionals and her knowledge and skills in mental health. The facilitator has provided numerous presentations to medical laboratory professionals on topics regarding mental health including anxiety, depression, burnout and uncertainty. She has also written articles for the medical laboratory profession outlining tangible strategies for these topics. She also previously worked as a researcher for CSMLS and is familiar with the different roles of an MLA, MLT, Educator and Manager. The facilitator/researcher was also a regulated mental health clinician within the province of Ontario and a certified counsellor with the Canadian Counselling and Psychotherapy Association.
Additionally, the facilitator introduced her background and knowledge; however, she delineated herself as a “civilian” within the peer support sessions to avoid confusion regarding her knowledge base in the field.
Session content
The first session of each peer support group featured an introduction by the facilitator, group introductions and an icebreaker, as well as an explanation of peer support and its purpose. The icebreaker assisted in developing connection and rapport within the group. The groups featured a PowerPoint which asked participants to explain what they wanted to bring or take away from the peer support groups. The participants were then asked about the role and its strengths/uniqueness as a medical laboratory professional. After the first session, each session started with a recap of the previous week and a space for questions/clarifications.
Within the second session, participants were split into small groups (of 2–3 people) via breakout rooms in Zoom. Participants were asked to consider questions regarding retention within the field and their current coping/stress management strategies.
The third session examined the messaging regarding mental health within the laboratory, knowledge and access of mental health supports, as well as a review of third-wave cognitive strategies, from Acceptance and Commitment Therapy (ACT), and focused on addressing overwhelming or stressful thoughts. The April and May sessions were similar until session three, as the April session followed the above-outlined schedule. The May session led to further discussion regarding mental health.
During the last session in April, participants focused on next steps re: changes within the lab, feedback on the peer support groups and for CSMLS, as well as reviewing mental health resources available to them. Within the last/fourth session in May, participants incorporated some of the ACT strategies, along with the information listed above regarding feedback, next steps and resources.
Data collection
All sessions were recorded via Zoom Business and securely stored within a password-protected file on the researcher’s password-protected laptop to which she only had access. After sessions, the researcher compiled analytical memos and notes to help outline pertinent discussions and thoughts from participants and develop later codes.
The researcher used Zoom’s transcription service to transcribe each video. She reviewed each video thrice to ensure she confirmed the transcribed information. The videos were deleted two months after the last peer support session.
Qualitative analysis preparation
To ensure the validity and reliability of data as well as foster transparency in qualitative research, the writer reviewed preliminary themes and information for research purposes with both April and May groups in their fourth session, respectively, and received feedback from participants.
Peer support sessions coding and analysis
Word clouds
The facilitator/researcher used the transcripts within NVivo to create word clouds for April and May. The first session transcript was also used to develop a word cloud of the pertinent information discussed regarding the role of a medical laboratory professional in both sessions.
Coding
The facilitator/researcher used both manual and computerized coding. NVivo software was used to develop themes and codes which the researcher reviewed while watching the videos. Prior to examining the themes and codes, filler words such as “um, ah, okay, yeah” were removed from the transcripts. The initial coding (first order) is provided for each peer support session within Tables 3 and 4 for April and May 2022, respectively. Additionally, due to the rich data collected the writer engaged in descriptive thematic analysis to develop themes. Saldana (2015) considered this to be a type of second cycle coding. The writer then completed a comparative analysis of both initial codes from April and May to develop pattern codes for further reflection.
Qualitative results
The following section outlines the qualitative results from the April and May peer support groups.
April 2022 qualitative results
Figure 1 outlines the overall responses provided when participants were asked to describe their role to a friend/relative as well as to generally describe the uniqueness and strengths of their role. April participants highlighted their role as medical laboratory professionals as the “silent firefighters” on the frontlines of health care. They noted their role developed a blueprint for health for patients and much of their role is “invisible”. When asked to describe their role to a friend outside of the field, many participants noted “we help doctors” as it is “too complicated” to describe in a simple manner. CSMLS was discussed within their responsibilities related to the importance of certification as well as training within the field.
April overview of peer support session responses
The April group participants explained their rationale for attending as a vested interest in learning more about mental health, resiliency and methods to support themselves and their colleagues in the lab environment. While the concept of peer support was explained, many participants expressed a preference for the facilitator to present information, rather than discuss it. Additionally, the participants noted an interest in learning more about CSMLS initiatives within mental health. To assist with facilitating discussion, a password-protected Google document was shared where participants could add thoughts regarding different topics after Session 2.
The April group also discussed political challenges within the profession, depending on their geographic location, such as proposed changes in regulation in Alberta. Overall, geographically, participants noted staffing issues and scheduling issues related to staffing and the impact of COVID-19/illness.
However, the majority of participants outlined moving for work and securing more consistent work with a move. For some participants had engaged in a move more than once and across the country to secure a role with permanent or consistent hours. The importance of their role within patient care was frequently highlighted and emphasized.
May 2022 qualitative results
Figure 3 highlights the overall responses provided when participants were asked to explain their role to a friend/relative and to generally list the uniqueness and strengths of their role.
May participants highlighted the importance of their role in health care, however, noted that they are “invisible”. They noted that “we give all the answers” and provided specifics with their tasks by stating: “take blood and examine specimen on slides”. They also discussed the role of CSMLS in the certification of their profession as all the May participants were MLTs. One participant also outlined a metaphor of “Where’s Waldo?” for their role, except it is “Where’s the issue?” or “Where’s the cancer?”
The facilitator/researcher used NVivo and created a word cloud with text from all the peer support sessions in May 2022. The word cloud is focused on discussions regarding the current lab context and their emotional well-being. The font size represents the prevalence of word usage, with larger font showing greater usage. Figure 4 shows a word cloud examining 100 of the most frequently used words by participants in May 2022. To examine the information from all sessions in May, the facilitator/researcher used NVivo to develop a word cloud whose text represents participants’ discussion regarding the current lab context, their emotional well-being and whose font size represents the prevalence of the word usage. Stemmed words were included, such as “talk” and “talking”. The six most common words are in orange font: CSMLS, learn, health, mental, talk, team. Due to the transcripts and videos, mental and health are combined for mental health. The May participants continued to highlight their qualifications and skills referring to CSMLS certification and professional development within their discussions. Furthermore, the words “learn, talk, team” are evidence of a growth perspective which was prevalent throughout the sessions. During the sessions, the May participants emphasized that their resiliency stems from their enjoyment of learning as well as their adaptability within their role. These concepts are further developed within their quotes and later, in codes and themes.
Comparison of April and May 2022 peer support session findings
The researcher manually reviewed the videos and transcripts to examine the initial coding and descriptive theme development. The researcher noted continued consistency within April and May sessions which led to the creation of pattern codes, overall themes from both sessions and the integration of metaphors. Metaphors assist with qualitative data analysis as they highlight participants’ knowledge and examples from sessions.
Within Table 3, similar codes and words from themes are bolded and themes that have a similar connotation are bolded.
The results shown above highlight the impact of stigma within the medical laboratory profession. One group noted that it was doubled for their profession with both societal and lab stigma towards mental health. Additionally, for those who sought mental health care, numerous barriers are evident with the cost of service and the concept of time. There were issues regarding access to care as well as time with participant schedules and availability to meet.
In regard to retention within the field, community, consistency, patient care, role and salary are codes that are well distributed throughout both groups’ transcripts and interactions. Medical laboratory professionals are committed to their role, their community, as well as patient care. These concepts were evident within the discussions held via Zoom. The April participants often used words such as patient care, lab, people, whereas the May participants had talk, team and learn as some of their most commonly used words.
In the April and May groups, there were MLTs who had moved to different areas of the country for work. As well, there were individuals who had taken a stress leave from work in the present. Within each group, there was an individual who was considering a career change or in the process of learning more to switch careers. However, individuals within both groups identified that they did not plan nor want to leave the medical laboratory profession. The samples for both groups featured individuals from rural and remote areas as well as urban areas of Canada. Another similarity is that both groups were interested in communicating with and assisting CSMLS in any way they could. They noted their appreciation for CSMLS within their profession.
Evaluation of peer support sessions
Both groups received an anonymous evaluation form for the peer support sessions after the final session was completed (see Appendix 1). The evaluation form was emailed as a Jotform document to participants. There were six participants who completed the April evaluation and six participants who completed the May evaluation.
April 2022 group
For the April 2022 completed evaluations, two completed all four sessions, two completed three sessions and two completed two sessions in total. For the May 2022 completed evaluations, five completed all four sessions and one attended three sessions. The participant responses to program content, program materials and engagement level of participants are outlined in Table 4. All participants chose Agree or Strongly Agree when responding to the statement “The peer support sessions validated my feelings about the medical laboratory profession”. The majority of participants (11) chose Agree in response to “The peer support sessions encouraged me to address my mental health” with one participant choosing Somewhat Agree.
All participants rated the facilitator’s communication skills, knowledge, professionalism and attitude as Highly Satisfied. Ratings for the facilitator’s attention and interest were focused on Very Satisfied with two participants choosing Satisfied. Table 5 outlines the participants’ familiarity with the resources presented within the peer support sessions.
Written feedback from the participants focused on the benefits, challenges, and any further thoughts on the peer support sessions. Overall, based on the facilitator’s experience and the evaluation, the peer support sessions allowed participants to share their experiences and provide support to one another. Some comments were reflective of the discussions regarding management, the impact of employee attendance and mental health within the April 2022 group. Some members also noted that personal reflections were brief within the group. Additionally, some group members did want more structured strategies for mental health to bring to their labs, which was reflected in the feedback. Participants also gained knowledge of different resources and noted encouragement and validation from the groups.
Based on the evaluations, the peer support sessions encouraged participants to address their own mental health, validated their experiences and increased their comfort level in discussing mental health.
Post-session contact
Some participants within both April and May groups noted hesitancy with peer support sessions and their application in the future with CSMLS. Some participants expressed interest in further peer support sessions in the future.
However, an interesting phenomenon occurred after both the April and May peer support sessions. After the April sessions, three participants emailed the facilitator with their experiences and opinions. Two noted their interest in future virtual peer support sessions with CSMLS as well as its benefits. One expressed engagement in a regular emotional check-in with a positive perspective with their coworkers. This feedback is an excellent example of the difference that peer support may have within the medical laboratory population. Medical laboratory professionals enjoy learning and development and these strengths were evident in the above example.
Another participant articulated the strengths of peer support within the medical laboratory population and how it may help to address barriers to seeking formal mental health support.
After the May 2022 group, the facilitator received emails from two participants regarding the peer support sessions. One participant emailed the facilitator to ask about using non-stigmatized language within mental health. This email shows the importance of education and awareness in addressing mental health stigma within the medical laboratory profession.
Another participant emailed the facilitator stating that they really understood the value of peer support groups for the medical laboratory population. They may investigate it for students within laboratory practicums. The feedback further emphasizes that peer support groups may be helpful for medical laboratory professionals.
Discussion
April overview of peer support session responses
Medical laboratory professionals were in managerial and frontline roles during the April sessions. The discussion also evolved into questions and concerns about increased sick time, attendance issues and consistency with scheduling. It was evident that roles and experiences impacted the discussion and that some members were uncertain as to how to support mental health in their workplace. The group also questioned engagement within a peer support network due to the increased stigma within the lab and at a societal level, respectively. The differences in roles appeared to impact the conversation within some sessions and led to some participants disclosing more to the facilitator after the session/individually.
Furthermore, the facilitator discussed the concept of stress as a “badge of honour” within the profession which resonated with the participants. As a metaphor, the badge of honour is now weighing heavily on medical laboratory professionals, rather than empowering them within their role.
May overview of peer support session responses
The May participants emphasized the importance of connection, fostering camaraderie within the field, as well as learning and sharing as many of the reasons that contributed to their participation. The participants noted these concepts were vital to collaborating and fostering knowledge about mental health. Many participants within the group disclosed past experiences with mental health either within individual or familial levels and noted the importance of growth and development to help address mental health. Additionally, many participants were from rural and remote areas of Canada and were aware of the issues in securing mental health services in their areas. The participants also highlighted their commitment to CSMLS and provided feedback to address further advocacy, services or research.
Within the May sessions, participants noted relocation to different areas of Canada for work. There were individuals who moved to rural and remote areas for opportunities and increased pay. A common discussion that arose was the stability and benefits of the job, especially during uncertain times (such as currently with the rising inflation costs in Canada). The discussion also evolved into questions and concerns about increased sick time, attendance issues and consistency with scheduling. It was evident that roles and experiences impacted the discussion and that some members were uncertain as to how to address mental health in their workplace and procure relevant resources. The group also questioned engagement within a peer support network due to the increased stigma within the lab and at a societal level, respectively.
Comparison of May and April peer support groups
While there are great similarities between both groups, there were also some important differences. The initial group experienced some challenges with discussing mental health support during an overwhelming time re: staffing shortages and attendance issues. However, upon reflection, some participants noted that addressing stigma and learning more empathic strategies would be beneficial in the long term. Additionally, the April group featured medical laboratory professionals within specific political situations based on the profession, some of which became featured in most of the discussions. For those who were in different areas or for whom it did not apply, it may have caused a disconnect with some of the discussion.
The April group briefly discussed some coping skills related to social connections and physical exercise within their sessions. However, many individuals referred to challenges with changing their mental health within an overworked environment. Within the May group, participants outlined strategies in regard to physical exercise, spending time with family and friends, hobbies, meditation and EFT (emotional freedom technique or “tapping”) to address their stress. This group also highlighted the importance of boundaries to relieve stress and gain space from work.Within the May group, while there were some individuals in leadership positions, they continued to reflect upon their experiences within the field, rather than those as a manager. The April group sessions focused on lab, learn and patient care (see Figure 2), whereas the May group discussions featured talk, team and learning (see Figure 4). The May participants highlighted their experiences in smaller laboratory environments as well as increased experience in rural and remote areas. This may have impacted their discussion and encouragement of camaraderie within the sessions.
It was evident that there was a greater level of rapport and camaraderie within the May 2022 group rather than the April 2022 group. This may be linked to differences in participants (more managers), political geographical implications within the April group, as well as requests for further tangible strategies rather than participant reflections.
Based on their presentation, the May group was more forthcoming with information than the April group. The facilitator noted rapport was developed between participants by the end of the first session.
Recommendations
The facilitator developed the following recommendations based on the data collected, data analysis and codes and themes developed. In addition, the evaluation and post-session feedback were considered, along with the recommendations and next steps.
The following initiatives and actions are recommended and are applicable to medical laboratory organizations which provide certification. CSMLS is encouraged to provide peer support sessions in a virtual format for CSMLS members in the future. The evaluation and post-session follow up identified strengths, growth and development from the peer support sessions. Both groups appreciated the inclusion of tangible strategies for mental health. Future considerations are to group individuals by discipline (microbiology, histology), geographically (East, West) or by role (re: Managers together vs Bench Tech). CSMLS is encouraged to continue to develop and provide mental health resources for medical laboratory professionals.
Many of the codes, themes and discussions focus on the gaps in knowledge surrounding mental health. Consequently, a training programme focused on mental health would address uncertainty and foster awareness and education regarding mental health and how to support someone with mental health. CSMLS should continue to advocate for the profession regarding the politics of regulation, staffing and conditions for medical laboratory professionals. CSMLS is engaged in initiatives from Lobby Day to National Medical Laboratory Week, as well as advertising and promoting the profession on various media and social media outlets. Based on the participants’ feedback, the advocacy by CSMLS may require further extension and engagement in rural areas of Canada. Medical laboratory professionals worldwide face increased stress and staff shortages and these recommendations would assist in addressing mental health and emotional well-being (Leber et al., 2022).
CSMLS should provide further advertising regarding the profession to assist the public in understanding and acknowledging it, for example, television ads to explain to the public the importance of their role.
Overall systemic changes are required at an organizational/hospital level throughout Canada. One such change might be the integration of the National Standard of Canada for Psychological Health and Safety in the Workplace which was developed by the Mental Health Commission of Canada (MHCC) in 2013. It is “a set of voluntary guidelines, tools and resources intended to guide organizations in promoting mental health and preventing psychological harm at work” (MHCC, 2013).
Based on the media releases on its website, CSMLS is aware of the challenges faced by medical laboratory professionals. However, for CSMLS to engage in systemically based change is an overwhelming undertaking. Their continued advocacy and support for members are greatly aligned with their role.
Conclusion
In Canada, medical laboratory professionals are doing an exemplary job with specimen and blood collection, testing and analysis and dissemination of results to providers within the health-care environment. They have experienced increased stress levels due to staffing, retirement, and workload issues over the past decade. However, their stress levels have continued to rise since the COVID-19 pandemic. The pandemic and its strain on the health-care system have impacted the medical laboratory science field. Within the pilot initiative, the facilitator heard from groups of medical laboratory professionals who emphasized their commitment to their role, patient care and standards within their careers. These concepts coupled with stability and remuneration assist with retention.
The peer support sessions provided a safe space for participants to discuss the context of their stress, workplace, perspectives on mental health and access to related resources. Individuals across Canada were able to connect virtually via Zoom to discuss their current roles and emotional well-being. This unique and initial study examined a specific Canadian health-care population and provided rich data to understand their work context.
The facilitator heard from individuals who acknowledged their role as “silent firefighters” or the “bass guitar” within the health-care system while highlighting their professional strengths.
While some individuals are stepping back from the profession, there are many more who plan to stay within this specialized field and would like to address their stress and emotional well-being. Participants noted that increasing stress would continue to impact them within their roles and their standards of work and systemically, changes in workload, messaging and staffing would assist in addressing their concerns.
Overall, the facilitator developed recommendations based on qualitative data analysis and participant feedback. CSMLS should continue piloting peer support sessions, with some minor adjustments, to address mental health, burnout and emotional well-being among medical laboratory profession.
Figures
Figure 1.
Session 1 April word cloud
Figure 3.
Session 1 May word cloud
Figure 4.
May Sessions word cloud
Figure 2.
April sessions word cloud
Participant roles within April peer support sessions
| Session no. | MLT | MLA | Educator | Supervisor/Director |
|---|---|---|---|---|
| Session 1 | 6 | 2 | ||
| Session 2 | 3 | 2 | ||
| Session 3 | 5 | 2 | ||
| Session 4 | 5 | 2 |
Source: Created by authors
Participant roles within May peer support sessions
| Session no. | MLT | MLA | Educator | Supervisor/Director |
|---|---|---|---|---|
| Session 1 | 5 | 1 | 1 | |
| Session 2 | 5 | 1 | 1 | |
| Session 3 | 4 | 1 | 1 | |
| Session 4 | 4 | 1 |
Source: Created by authors
Comparison of initial April and May data with pattern code and overall theme development
| Initial Coding April 2022 | Initial Coding May 2022 | Themes April 2022 | Themes May 2022 | Pattern codes | Overall themes and metaphors |
|---|---|---|---|---|---|
| Cost Wait times Counsellor rapport Shift work / scheduling EAP is limited |
Accessibility Time Cost Awareness |
Medical laboratory professionals encounter numerous barriers to mental health care | Barriers to accessing mental health care are prevalent for medical laboratory professionals | Cost Time Resource awareness |
Medical laboratory professionals continue to encounter barriers to accessing mental health care |
| Mental health stigma Fear of being weak/letting down the team Judgment |
Disconnect Mental health stigma Messaging Invalidation |
Stigma is a barrier to accessing mental health care. Managers and upper-level administrators play a vital role in morale and retention. Changes in organizational messaging can assist in addressing mental health and stress | Mental health stigma is doubled for medical laboratory professionals | Stigma Messaging Strength Weakness Frustration |
Stigma regarding mental health is rampant for medical laboratory professionals. Medical laboratory professionals often experience mixed-messaging regarding mental health |
| Stress Support Time Workload |
Stress Overwhelmed Workload Strategies Coping Managerial |
The laboratory environment continues to be stressful. Many MLTs are learning more about mental health services and trying to develop coping strategies for their mental health | The stress level of the lab has grown exponentially and time is at a premium. Resources are prioritized for public health/COVID testing | Stress Workload Challenges |
Medical laboratory professionals are: Invisible silent firefighters MLTs would like to manage stress better but their increasing workload demands and challenges with scheduling and staffing add to their stress. Badge of honour is heavy |
| Salary Consistency Role Patient Care Ethics Community Standards Impact Training |
Salary Consistency Role Patient Care Community Knowledge Learning Development Resilient Capable |
MLTs are committed to patient care, as well as their workloads and their colleagues. Medical laboratory professionals are a resilient and adaptable group which is fostered by their responsibilities and duties MLTs are committed to their role. They are lifelong learners who continue to adapt and grow even within stressful environments. Few want to disregard their training and start over |
Medical laboratory science is a career. Patient care strongly contributes to retention Consistency and salary assist in retention in the lab Fostering skills and knowledge with training and mentoring is empowering and fosters collaboration when peers also stay in the role |
Commitment Patient Care Community Loyal Honest Compassionate |
Medical laboratory professionals are committed to their role Badge of honour to be a medical laboratory professional The bass guitar of the hospital |
Source: Created by authors
Participants’ satisfaction level with program content, materials and participant engagement level
| Program components | Not satisfied | Somewhat satisfied | Satisfied | Very Satisfied |
|---|---|---|---|---|
| Program content | 1 | 6 | 5 | |
| Program materials | 5 | 7 | ||
| Engagement level of Participants | 5 | 7 |
Source: Created by authors
Participants’ familiarity with resources provided within the peer support sessions
| Evaluative statement | Had heard about and did not use | Had not heard about and will use/access them | Had heard about and used before | Had not heard about and am uncertain if I will use them |
|---|---|---|---|---|
| The peer support sessions provided me with resources that I… | 5 | 3 | 3 | 1 |
Source: Created by authors
| Not satisfied | Somewhat satisfied | Satisfied | Very satisfied | N/A | |
|---|---|---|---|---|---|
| Program content | |||||
| Program materials | |||||
| Engagement level of participants |
| Not satisfied | Somewhat satisfied | Satisfied | Very satisfied | N/A | |
|---|---|---|---|---|---|
| Communication skills | |||||
| Facilitator’s attention and interest | |||||
| Facilitator’s knowledge and professionalism | |||||
| Facilitator’s attitude |
Appendix 1. CSMLS peer support sessions evaluation
Of the 4 peer support sessions, I attended
All 4
3
2
1
Please evaluate the peer support session(s) for the following areas:
The peer support sessions were
Extremely helpful
Very helpful
Somewhat helpful
Slightly helpful
Not helpful
The peer support sessions validated my feelings about the medical laboratory profession
Strongly agree
Agree
Somewhat agree
Somewhat disagree
Disagree
Strongly disagree
The peer support sessions encouraged me to address my mental health
Strongly agree
Agree
Somewhat agree
Somewhat disagree
Disagree
Strongly disagree
Reflecting back on the session(s) you attended, what was beneficial?
(Participants were given a textbox to write their responses).
Reflecting back on the session(s) you attended, what was challenging?
(Participants were given a textbox to write their responses).
Please evaluate the facilitator for the following areas.
The peer support sessions provided me with resources that I
Had heard about and did not use
Had heard about and used before
Had not heard about and am uncertain if I will use them
Had not heard about and will use/access them
In your opinion, what content or activities were missing from the peer support sessions?
(Participants were given a textbox to write their responses).
After the peer support session(s) I attended, I am _____ talking about my mental health
Very comfortable
Comfortable
Same comfort level as before
Less comfortable
Not comfortable
Any additional comments or feedback on the peer support session(s) you attended:
(Participants were given a textbox to write their responses).
Thank you for completing the evaluation and for your participation in the peer support sessions!
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Acknowledgements
The authors thank CSMLS for supporting this important project.
Corresponding author
About the authors
Dr Rosina E. Mete is the Director of Faculty in the Masters of Counselling Psychology program at Yorkville University in Canada. She has also worked as a registered psychotherapist for ten years and specializes in supporting individuals with depression, anxiety, trauma, eating disorders, chronic pain and chronic illness. Her research interests and publications include mental health care, addressing stigma, leadership development and technology in education.
Dr Brandon Djukic is the Canadian Society for Medical Laboratory Science research manager, and has been with the organization since 2020. He holds a Bachelor of Science and Doctorate of Philosophy in chemistry, with additional education in statistics and data science.
Christine Nielsen became Chief Executive Officer of the Canadian Society for Medical Laboratory Science in 2010. Trained as a medical laboratory technologist, she has a degree in Health Admin, a Certificate of Mastery in Prior Learning Assessment from DePaul University, Chicago, and is a Certified Association Executive (CAE). She recently completed an MBA from Heriot-Watt, Edinburgh Business School, Scotland. Christine is past Chair of CNAR – the Canadian Network of Agencies of Regulation, Ottawa. She is also an experienced Prior Learning Assessment Assessor with the Canadian Society of Association Executives (CSAE), and Chair of the CAE Advisory Group.